OVERVIEW OF SEPSIS/ BACTERIAMIA Flashcards
Septicaemia / bacteriamia
A _________________________ infection
Occur when a bacteria elsewhere in the body _____________________ of the lung ,urinary tract, skin abdomen
Bacteria toxin are carried thorough out entire body
SEPSIS , When _____________________________
Serious blood stream
enter the blood stream
a bacteremia triggers body responses
With complication of septicemia ,_____________ occurs through out the body causing _________ and block ___________ throughout the body result in organ failure
inflammation
blood clot
oxygen supply
When SEPSIS occur with ____________________, it is called septic shock
extremely low blood pressure
In septic shock, Blood pressure is low despite treatment with _______
inflammation triggered by __________ causing blood vessels to _________ leading to ___________
causes tiny clot in organs heart lung kidneys and brains
fluid
cytokines; dilate; hypotension
Features of sepsis
___________ or ___________
Weakness
___________
___________/ abnormally _______ white blood cells
Fever or hypothermia
Weakness
Tachycardia
Increase/ abnormally low white blood cells
DETERMINANTS of sepsis
LOW ______________
POOR _____________ COVERAGE
POVERTY
OVER CROWDING
_____________
ILLITRACY
CONFLICT/ POOR _____________
NATURAL DIASTERS
BREAST FEEDING RATE
IMMUNIZATION
MALNUTRITION
SANITATION
Sources of bactemia
____________ ‘
_______ infections BURNS
_______
_______ tract
Newborn Infections
_______ tract
Sources of bactemia
Pneumonias ‘
skin infections BURNS
ABDOMEN
Urinary tract Newborn Infections Genital tract
SEPSIS AND SHOCK
_______________________________( SIRS)
(Specific or Non specific?) inflammatory response to infection, burns and surgery and comprise of two abnormality one which must be ____________ or _______
________
________ rate
_________ function
peripheral _________
SEPSIS AND SHOCK
SYSTERMIC INFLAMAMTORY RESPONDSE SYNDROME
Non specific ;temp instability ; WBC
Body temp
Heart rate
Respiratory
W.B.C
Sepsis
__________ In presence of or result of __________
Severe sepsis: __________ plus __________ dysfunction
acute respiratory distress syndrome: ———— or more _______________
SIRS ; proven infection
sepsis ; Cardiovascular function
Two ; organ dysfunction
SEPTIC SHOCK
Septic shock: __________ with ______ dysfunction, hypotension bp < ____% centile for age
severe sepsis
CVS dysfunction
5%
_______ septic shock , _______ , shock compensated :Warm phase of shock will respond to fluids and pharmacologic medications
__________ or ___________ shock: late decompensation phase
lasting more than _______. despite vigorous therapy necessitating ___________ support
Early; warm
Cold or refractory
1 hr; vasopressin
Signs and features of SIRS
GENERAL PARAMETERS
Fever> _______
Hypothermia<______
Tachycardia ______ above normal
Tachypnoea
____________ state
Significant __________ or positive fluid balance> ______ml over 24hours
Hyperglycemia < 2 ______mmol/L or _____mg/dL in absence of diabetes Hypoglycemia < _____mmol/L in absence of metabolic compromise
38
36
2SD
Altered mental
oedema
20ml
6.67mmol/L ; 120mg/dL
2.75mmol/L m
Inflammatory parameters
Leucocytosis( white cell count >_______ /mm3)
• leucopenia ( white cel count <________/mm3
• Nrmal white cell with ______% immature forms bands
• Plasm CRP >_______
• Serum procalcitonin> ________ above normal value
•__________ mircoerythocyte sedimentation rate above Normal for age
12000
4000
10; 2SD; 2SD
elevated
Haemodynamic parameters
Arterial hypotension systolic bp <_____ below normal for age
Mixed venous oxygen saturation >_______%
Cardiac index > ____L/min/m2
2sd
70
3.5
Organ dysfunction parameters
Arterial hypoxaemia
Acute Oliguria<______m/kg for at least ________
Creatinine Increase of ______mg/dl
Coagulation abnormalities INR >_____, APTT >________
Ileus
Thrombocytopenia <_________
Hyperbilirubinaemia > _____mg/dL
0.5; 2hours
0.5; 1.5; 60 sec
100,000; 4
Tissue perfusion parameters
Hyperlactaemia > ____mmol/l
__________ capillary refill or __________
3
Decrease
mottling
Management
Initial resuscitations A,B,C
avoid ________ if possible
Crystalloid or colloids ______mg/kg over ______ , can be repeated up to _____ times total ______ml/kg
correct _________
Correct _____________
In Difficult or refractory shock give ________ agents
sedatives
20; 10 min
3; 60; hypoglycaemia
hypocalcaemia; inotropic
Inotropic agent
Dopamine ______ ug/kg/min
or dobutamine _______ug/kg/min
5-15
5-15
• • • • • •
If dopamine and dobutamine fails give ___________ ___-___ug/kg/min
Titrate to optimal urine output and vital signs conscious state
monitor BP and capillary refill
Cold extremities
Take sample for investigations
give appropriate antibiotics
adrenaline 0.05-2
Investigations to be done in SEPSIS
LIST 6
BLOOD CULTURE
BACTEC
URINE CULTURE
STOOL CULTURES
CHEST XRAY
CRP
WBC
Standard Precautions
Definition: a set of precautions designed to ??????????
prevent transmission of HIV, HBV and other blood borne pathogens when providing first aid or health care (CDC definition)
Under Standard precautions, blood and certain body fluids of all patients are considered _______________________________.
potentially infectious for HIV, HBV and other blood-borne pathogens
Standard Precautions (I)
Includes:
–____________
– Use of ______________
–___________ hygiene and_________ etiquette
– Safe __________ practices
– Cleaning and disinfection of environmental surfaces
Hand hygiene
Personal Protective Equipment (PPE)
Respiratory; cough
injection
